Retrospective evaluation of patients diagnosed with urinary tract infection

Urinary system infections encompass a wide spectrum ranging from asymptomatic bacteriuria to urosepsis. This study evaluated the demographic characteristics, risk factors, treatment, and antibiotic resistance profiles of patients hospitalized with a diagnosis of urinary system infection in the Department of Infectious Diseases at Trakya University Health Research and Application Center. A total of 119 patients who were followed between January 1, 2016, and December 31, 2017, were included in the study. The cases were divided into two groups as complicated (73.9%) and uncomplicated (26.1%). Among the cases, 57.1% were female, and 42.9% were male. The median age was 73.5 years in the complicated group and 45 years in the uncomplicated group (p<0.001). Hypertension (p<0.001), neurological pathologies (p=0.003), and malignancies (p=0.004) were more frequently observed in the complicated group. The most common complicating factors were urinary catheterization (33.6%) and a history of urinary stones (16.8%). In empirical treatment, the most frequently used antibiotics were piperacillin-tazobactam in the complicated group (28.2%) and ceftriaxone in the uncomplicated group (26.5%). In urine cultures, Escherichia coli was the most commonly isolated pathogen in both groups (p=0.043). Extended-spectrum beta-lactamase positivity was higher in the complicated group (26.1%) compared to the uncomplicated group (3.2%) (p=0.001). It was observed that the risk of extended-spectrum beta-lactamase positivity increased nine times with antibiotic use in the previous month (p<0.005) and six times with a history of urological procedures in the past six months (p=0.001). In Escherichia coli isolates, resistance to ampicillin, amoxicillin-clavulanate, gentamicin, and cephalosporins was higher in the extended-spectrum beta-lactamase-positive group compared to the extended-spectrum beta-lactamase-negative group (p<0.001). The duration of hospital stay was longer in the complicated group (p<0.001), while the duration of outpatient treatment was longer in the uncomplicated group (p<0.001). No mortality was observed in the study.